Illness Anxiety Disorder cognitions and behaviour


When you suffer from illness anxiety (also known as hypochondria), you are afraid that you have a serious illness. Physical symptoms, whether they can be medically explained or not, are interpreted from an anxious perspective.

If you feel something weird in your body and are afraid that you might have a serious illness, it can cause you to feel a lot of tension. When experiencing heart palpitations, stomach complaints, muscle tension or fatigue, for example. These physical complaints lead to even more attention being focused on the anxiety of having a serious illness. This unpleasant feeling causes you to perform anxiety-reducing behaviour: you will try to find ways to get rid of the anxiety as quickly as possible. For example, you might avoid certain situations or do research on your symptoms. You might also use safety behaviour. This behaviour also influences your physical symptoms in the short and long term. Consider, for example, the deterioration of your physical fitness by avoiding exercise or the development of spots or bumps due to continuously touching a certain body part or area.


With the help of your professional, you will list your cognitions (thoughts and thinking styles) and behaviour associated with the illness anxiety disorder to gain more insight into your anxiety.


Examples of Illness Anxiety thinking styles:

  • Mental filter: Using only one situation and ignoring others to reach a conclusion. For example: I am having heart palpitations, which must mean I am having a heart attack.
  • Overgeneralization: Drawing general conclusions based on one fact. For example: No one understands me.
  • Jumping to conclusions: Drawing conclusions based on arbitrary assumptions. For example: If I feel sick, everyone will think I’m ridiculous.
  • Catastrophizing: Assuming the worst-case scenario will materialize. For example: If I have heart palpitations, I will have a heart attack and die.
  • Personalization: incorrectly relating situations to yourself. For example: The chance of getting a brain tumour is small, but it will happen to me.
  • Probability overestimation: Overestimating the probability that something will occur. For example: If I feel something unusual in my body, it is 100% a sign of a serious illness.
  • Magical thinking: Believing that thoughts and ideas eventually lead to actual situations. For example: If I think about cancer, I will get it as well.


Examples of thoughts:

  • I must be absolutely sure that this phenomenon is not dangerous.
  • Only someone else can reassure me.
  • If I feel something weird in my body, it is a sign of a serious illness.
  • I am 100% sure what this physical symptom means.
  • When I’m healthy, I shouldn’t feel anything unusual in my body.
  • If I’m worried about a serious illness, I will end up getting it.


Examples of illness anxiety (safety) behaviour:

  • Seeking reassurance by going to the doctor.
  • Control behaviour, such as touching or visually inspecting the body, checking bowel movements, searching for information on the Internet.
  • Avoidance behaviour, where you avoid certain activities. Consider, for example, avoiding certain foods, sports, social interactions or TV programs.



Keijsers, G. P. J., Van Minnen, A., Verbraak, M., Hoogduin, C. A. L. & Emmelkamp, P., (2017). Protocollaire behandelingen voor volwassenen met psychische klachten.

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